The clinical research and patient care core programs for the Northern California Comprehensive Sickle Cell Center (NCCSCC) application are based in the East Bay at Children's Hospital and Highland Hospital Oakland, and in the West Bay at San Francisco, General Hospital/University of California, San Francisco. The large patient population enrolled in these cooperative clinical programs provides an ideal source to conduct clinical and basic research projects as proposed. Since 1978, the multi- disciplinary staff of our center has met on a regular basis to discuss patient management issues, evaluate ongoing clinical and basic research projects, and plan new research. The success of these interactions is reflected in our publications related to basic and clinical research on sickle cell disease (listed in the summary progress report), in our participation in national efforts to establish treatment guidelines for patients with sickle cell disease and in our contribution to understanding the etiology and mechanism of sickle cell clinical complications. This application describes a number of new clinical research projects: 1) anti- sickling agents including hydroxyurea-sodium phenylbutyrate, magnesium therapy, clotrimazole; 2) Deferiprone (L1) therapy; 3) CNS ischemia; 4) bone marrow transplant in the treatment of sickle cell disease; 5) core blood transplant and the development of a minority cord blood donor program. In addition the above project, the core will proved necessary samples for many basic research projects. In summary, the strength of the clinical core in our center application will enable us to complete successfully the proposed clinical research projects, participate in basic research and improve the understanding of the etiology and treatment of many sickle cell complications.